(1) Each hospital shall implement a written hospital-wide nurse staffing plan that: (a) Meets the requirements of this section and ORS 441.762, 441.764, 441.765, 441.766, 441.767 and 441.768; (b) Includes any staffing-related terms and conditions that were previously adopted through any applicable collective bargaining agreement, including meal breaks and rest breaks, unless a term or condition is in direct conflict with an applicable statute or administrative rule; and (c) Has been developed and approved by the hospital nurse staffing committee under ORS 441.762. (2) If the nurse-to-patient ratios in ORS 441.765 apply, the hospital nurse staffing committee: (a) May consider: (A) The specialized qualifications and competencies of the nursing staff and the skill mix and level of competency needed to ensure that the hospital is staffed to meet the health care needs of patients; (B) The size of the hospital and a measurement of hospital unit activity that quantifies the rate of admissions, discharges and transfers for each hospital unit and the time required for a direct care registered nurse belonging to a hospital unit to complete admissions, discharges and transfers for that hospital unit; (C) The units general and predominant patient population as defined by the Medicare Severity Diagnosis-Related Groups adopted by the Centers for Medicare and Medicaid Services, or by other measures for patients who are not classified in the Medicare Severity Diagnosis-Related Groups; (D) Nationally recognized evidence-based standards and guidelines established by professional nursing specialty organizations, if any; (E) Differences in patient acuity; and (F) Tasks not related to providing direct care; and (b) Must comply with ORS 441.765. (3) A hospital must maintain and post, in a physical location or online, a list of on-call nursing staff or staffing agencies to provide replacement nursing staff in the event of a vacancy. The list of on-call nursing staff or staffing agencies must be sufficient to provide for replacement nursing staff. (4)(a) An employer may not impose upon unionized nursing staff any changes in wages, hours or other terms and conditions of employment pursuant to a staffing plan unless the employer first provides notice to and, upon request, bargains with the union as the exclusive collective bargaining representative of the nursing staff in the bargaining unit. (b) A staffing plan does not create, preempt or modify a collective bargaining agreement or require a union or employer to bargain over the staffing plan while a collective bargaining agreement is in effect. (5) A hospital shall submit to the Oregon Health Authority a nurse staffing plan adopted in accordance with this section and ORS 441.766 and submit any changes to the plan no later than 30 days after approval of the changes by the hospital nurse staffing committee. (6) A type A or a type B hospital may vary from the requirements of ORS 441.765 if the hospital nurse staffing committee of the hospital has voted to approve the variance. A type A hospital or type B hospital shall notify the authority of the variance through the authoritys website. The notification to the authority shall include a statement signed by the cochairs of the committee, confirming that the committee voted to approve the variance. The variance becomes effective upon the submission of the notification to the authority and remains in effect for two years. A type A or type B hospital may renew a variance or notify the authority of a new variance as provided in this subsection. [Formerly 441.155; 2025 c.506 3] Note: See note under 441.761. Note: Section 29, chapter 507, Oregon Laws 2023, provides: Sec. 29. (1)(a) A nurse staffing plan that is in effect on the effective date of this 2023 Act [September 1, 2023] that does not comply with ORS 441.152 to 441.177 [series became 441.761 to 441.795] continues in force until a hospital nurse staffing committee revises the plan or develops a new plan. The committee shall revise the plan, or develop a new plan, to comply with ORS 441.152 to 441.177 no later than June 1, 2024. (b) A hospital must be in compliance with section 6 of this 2023 Act [441.765] no later than June 1, 2024. (c) A nurse staffing plan that is in effect on the effective date of this 2023 Act and that complies with ORS 441.152 to 441.177 remains in effect until revised in accordance with ORS 441.154 [renumbered 441.762]. (2) A hospital must establish a hospital professional and technical staffing committee and a hospital service staffing committee in accordance with sections 3 [441.775] and 4 [441.776] of this 2023 Act no later than December 31, 2024. (3)(a) Except as provided in subsection (4) of this section, the Oregon Health Authority may begin the enforcement of: (A) Sections 3 and 4 of this 2023 Act on the date specified in subsection (2) of this section; (B) Section 6 of this 2023 Act on the date specified in subsection (1) of this section; and (C) The amendments to ORS 441.020, 441.151 [renumbered 441.760], 441.152 [renumbered 441.761], 441.154, 441.155 [renumbered 441.763], 441.156 [renumbered 441.764], 441.164 [renumbered 441.778], 441.165 [renumbered 441.769], 441.171 [renumbered 441.791], 441.173 [renumbered 441.780], 441.175 [renumbered 441.793] and 441.177 [renumbered 441.783] by sections 1, 13, 14, 16, 18, 19 and 21 to 26 of this 2023 Act on the effective date of this 2023 Act. (b) The authority shall adopt rules to implement the process for receiving complaints under ORS 441.171 and section 12 of this 2023 Act [441.790] no later than January 1, 2024. Complaints may be filed for any violation occurring on or after the effective date of this 2023 Act. (4) The authority may not impose civil penalties under section 20 of this 2023 Act [441.792] for violations that occur before June 1, 2025.
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